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DR. MARK J MILLS D.D.S.
Orthodontics and Dentofacial Orthopedics >> Dentist >> Dental ProvidersRegistrant NPI Number: 1487848065
Individual Registrant:DR. MARK J MILLS D.D.S.
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
10 RUPERT ST MONTE VISTA, CO 81144-1042 US
Tel: 719-852-3011 Fax: --
Tel: 719-852-3011 Fax: --
Contact information for business:
3355 N ACADEMY BLVD BOX 633 COLORADO SPRINGS, CO 80917-5103 US
Tel: 719-641-6587 Fax: 719-683-5974
Tel: 719-641-6587 Fax: 719-683-5974
Registration Information:
NPI: 1487848065
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 1223X0400X | Dental Providers Dentist Orthodontics and Dentofacial Orthopedics | CO | 3617 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
